1.Glucocorticoids Combined with Cyclophosphamide and Rituximab in the Treatment of Elderly Patients with ANCA-associated Vasculitis and Renal Involvement: A Single Center Retrospective Study
Jiahui WANG ; Xin LEI ; Xiaohan HUANG ; Liangliang CHEN ; Yaomin WANG ; Pingping REN ; Lan LAN ; Jianghua CHEN ; Fei HAN
Medical Journal of Peking Union Medical College Hospital 2026;17(2):346-357
To investigate the efficacy and safety of glucocorticoids combined with cyclophosphamide (CTX) and rituximab (RTX) in elderly patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis with renal involvement. Elderly patients (age ≥60 years) with ANCA-associated vasculitis and renal involvement admitted to the First Affiliated Hospital, Zhejiang University School of Medicine from December 2019 to November 2022 were retrospectively enrolled. Based on different induction treatment regimens, patients were divided into a control group (glucocorticoids + CTX) and a combination therapy group (glucocorticoids + CTX + RTX). Differences in disease remission, end stage renal disease (ESRD), mortality, relapse, and incidence of adverse events were compared between the two groups. A total of 60 elderly patients with ANCA-associated vasculitis and renal involvement were ultimately included, with a median follow-up of 29.7(17.2, 38.7) months. The control group comprised 26 patients, with a median follow-up of 35.0(28.1, 40.3) months; the combination therapy group comprised 34 patients, with a median follow-up of 26.2(16.1, 35.1) months. The remission rate at 3 months (64.7% For elderly patients with ANCA-associated vasculitis and renal involvement, the regimen of glucocorticoids combined with CTX and individualized RTX demonstrates potential advantages in early remission rate, glucocorticoid tapering, and control of cumulative CTX dose, without increasing the risk of serious adverse events. This regimen may represent an alternative treatment option for this patient population; however, its long-term efficacy and safety require further validation through prospective randomized controlled trials.
2.Protective effect of the active component DMDD from Averrhoa carambola root on myocardial injury in diabetic mice and its correlation with the NCOA4/FTH1/ATG8 axis
Yongxin CHEN ; Yuxuan LI ; Kailei GU ; Jiajun YOU ; Xiaohan SUN ; Jing MA ; Yanping ZHOU ; Xiaojie WEI
China Pharmacy 2026;37(9):1141-1147
OBJECTIVE To investigate the protective effect of 2-dodecyl-6-methoxy-2,5-diene-1,4-cyclohexanedione (DMDD), an active component from Averrhoa carambola root, on myocardial injury in diabetic mice based on the nuclear receptor coactivator 4/ferritin heavy chain 1/autophagy-related protein 8 (NCOA4/FTH1/ATG8) axis. METHODS The successfully modeled diabetic mice were randomly divided into model group and DMDD low-, medium-, and high-dose (12.5, 25, 50 mg/kg) groups, while an additional non-modeled control group was established, with 6 mice in each group. Each group received the corresponding drug solution or an equal volume of normal saline intragastically once daily for 21 consecutive days. After the administration, the levels of fasting blood glucose (FBG), serum lactate dehydrogenase (LDH), and creatine kinase isoenzyme MB (CK-MB) were measured. Myocardial pathological changes, degree of fibrosis, and myocardial cell ultrastructure were observed. Myocardial cell death index and NCOA4 protein positive index were detected. The protein expression levels of NCOA4, FTH1, ATG8, solute carrier family 7 member 11 (SLC7A11), and glutathione peroxidase 4 (GPX4) in cardiac tissue were measured. RESULTS Compared with model group, each DMDD group showed significant alleviation of cardiac pathological injury and varying degrees of improvement in the myocardial cell ultrastructure. The FBG and serum LDH and CK-MB levels, the myocardial cell death index and NCOA4 protein positive index,the protein expression levels of NCOA4, FTH1, and ATG8 in cardiac tissue were significantly decreased ( P <0.001), while the protein expression levels of SLC7A11 and GPX4 were significantly increased ( P <0.001). CONCLUSIONS DMDD can reduce blood glucose levels, alleviate myocardial histopathological injury, and inhibit cell death in diabetic mice. The mechanism is associated with inhibiting excessive activation of the NCOA4/FTH1/ATG8 axis and reducing ferritinophagy.
3.Network meta-analysis of pneumonitis and interstitial lung disease associated with antibody-drug conjugates in the treatment of breast cancer
Xiaohan WANG ; Wei CHEN ; Fang YANG ; Keming CAO ; Jingxin WANG ; Wenxin XUE
China Pharmacy 2026;37(10):1370-1375
OBJECTIVE To compare the risk of pneumonitis and interstitial lung disease (ILD) associated with different antibody-drug conjugates (ADC) in the treatment of breast cancer. METHODS CNKI, VIP, PubMed, Embase and other Chinese and English databases, and ClinicalTrials.gov were searched from the inception to June 15, 2025. Randomized controlled trials (RCT) about pneumonitis and ILD associated with ADC (T-DM1, T-DXd, SG, Dato-DXd, SHR-A1811,ARX788, and T-Duo) in the treatment of breast cancer were included. After literature screening, data extraction, and quality assessment, a network meta-analysis was conducted using Stata 17.0 software, and the surface under the cumulative ranking curve(SUCRA) of all interventions were ranked. RESULTS A total of 19 RCTs involving 10 556 patients were included. The overall incidence of pneumonitis with ARX788 and T-DXd was significantly higher than that with T-DM1, T-DM1 plus TPC(T-DM1combined with pertuzumab or atezolizumab), TPC(treatment of primary care), and SG ( P <0.05), for grade 1-2 pneumonitis, ARX788 and T-DXd showed significantly higher incidence than T-DM1, T-DM1 plus TPC, and TPC ( P <0.05). For both indicators, ARX788 and T-Duo were ranked as the top two by SUCRA. For the incidence of grade ≥3 pneumonitis, T-DXd and T-DM1 were significantly higher than SG ( P <0.05), T-Duo and Dato-DXd were ranked as the top two by SUCRA. For overall incidence of ILD, ARX788 was significantly higher than T-DM1, SHR-A1811, TPC, and SG ( P <0.05), for the incidence of grade 1-2 ILD, ARX788 was significantly higher than T-DM1, SHR-A1811, and TPC ( P <0.05), for the incidence of grade ≥3 ILD, ARX788 was significantly higher than TPC ( P <0.05). For three indicators above, ARX788 and T-DXd combined with pertuzumab were ranked as the top two by SUCRA. CONCLUSIONS Compared with other ADCs, ARX788 and T-Duo are associated with a higher risk of pneumonitis and ILD in patients with breast cancer.
4.Timing of Termination and Cost-Effectiveness Analysis of Acupuncture for Acute Peripheral Facial Paralysis:A Randomized Controlled Trial
Xiaohan ZHANG ; Tao WANG ; Jinbo WANG ; Yiwen MIAO ; Lijuan DAI ; Jiaying ZHANG ; Shulan WANG ; Hui WANG ; Guoxin WANG ; Yuhang CHEN ; Xinjun WANG ; Bingguo XU
Journal of Traditional Chinese Medicine 2026;67(11):1185-1191
ObjectiveTo investigate the optimal termination time for acupuncture in treating patients with acute peripheral facial paralysis and its cost-effectiveness. MethodsA total of 120 eligible patients with acute-stage peri-pheral facial paralysis were randomly assigned to either the mild dysfunction termination group and the complete recovery termination group, with 60 patients in each group. Both groups received the standard acupuncture treatment protocol. Treatment in the mild dysfunction termination group was terminated when the Sunnybrook facial grade scale (SFGS) score first reached or exceeded 83 points, while that in the complete recovery termination group was terminated when the SFGS score first reached or exceeded 95 points. Assessments were conducted before treatment, 6 and 12 months after onset. SFGS, facial disability index (FDI) including physical function (FDIp) and social function (FDIs), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) scores were assessed before treatment, and 6 and 12 months after onset. Any acupuncture-related adverse events during treatment were recorded for safety evaluation. Treatment sessions and medical costs including direct costs, indirect costs, insurance coverage, total societal costs, and patient out-of-pocket expenses were also recorded, and an economic evaluation was conducted including cost-effectiveness ratio (CER) and incremental cost-effectiveness ratio (ICER). ResultsUltimately, 56 patients in the mild dysfunction termination group and 55 in the complete recovery termination group completed the follow-up. At 6 and 12 months after onset, SFGS and FDIp scores in both groups improved significantly while FDIs, SAS and SDS scores decreased (P<0.05). Comparison of scores between groups 6 months and 12 months after onset showed no statistically significant differences (P>0.05). During the trial, the incidence of adverse events was 13.3% (8/60) in the mild dysfunction termination group and 18.3% (11/60) in the complete recovery termination group, with no statistically significant difference (P>0.05). The number of treatment sessions, total social costs, and out-of-pocket expenses in the mild dysfunction termination group were significantly lower than those in the complete recovery termination group (P<0.05). The CER of the mild dysfunction termination group in SFGS, FDIp, FDIs, SAS, and SDS scores was lower than that of the complete recovery termination group. The ICER analysis showed that continuing treatment until full recovery incurred an additional cost of 573.30 CNY/point in SFGS improvement, whereas 1-point improvement in FDIp, FDIs, SAS, and SDS required 21,355.25 CNY, 1779.60 CNY, 3713.96 CNY, and 2755.52 CNY, respectively. ConclusionFor acupuncture in treating acute peripheral facial palsy, terminating treatment when mild dysfunction is achieved yields long-term efficacy comparable to that of continuing treatment until complete recovery, while significantly reducing medical costs and socioeconomic burden.
5.Discussion on processing time for Polygonatum kingianum based on analysis of correlation between sugar components and color changes
GUO Hong ; YAO Rui ; LI Zhe ; FAN Jing ; WANG Ying ; GUO Xiaohan ; CHEN Jia ; DUAN Baozhong ; YANG Jianbo ; JING Wenguang ; CHENG Xianlong ; WEI Feng
Drug Standards of China 2026;27(1):0083-0091
Objective: To investigate the correlation between color parameters (L*, a*, b*, Eab*) and the contents of reducing sugars, total polysaccharides, total oligosaccharides, as well as four saccharides (fructose, glucose, sucrose, and kestose) during the nine cycles of steaming and sun-drying processing of Polygonatum kingianum, and to preliminarily explore the optimal processing duration.
Methods: The color changes were objectively evaluated using a colorimeter. The anthrone-sulfuric acid method was employed to determine total polysaccharides and oligosaccharides. The 3,5-dinitrosalicylic acid (DNS) colorimetric method was used to measure total reducing sugar content. High-performance liquid chromatography coupled with charged aerosol detection (HPLC-CAD) was applied for quantitative analysis of fructose, glucose, sucrose, and kestose. Multivariate statistical analysis was conducted to assess samples from different processing stages.
Results: Significant variations in color and component contents were observed across processing stages. The herbal pieces progressively darkened with increased processing cycles: brightness (L*) and total color difference (Eab*) initially decreased then stabilized, while a* (red-green) and b* (yellow-blue) values first increased then declined. Total polysaccharides and oligosaccharides showed overall decreasing trends, whereas reducing sugars initially increased before stabilizing. Fructose and glucose levels rose continuously, while sucrose and kestose decreased progressively, becoming undetectable after five cycles.
Conclusion: The chromatic alteration and saccharide composition of P. kingianum showed significant correlation with processing duration. Both total color difference (Eab*) and reducing sugar content stabilized after four processing cycles (12 hours), suggesting that four cycles of steaming and sun-drying may represent the optimal processing duration.
6.Analytical research on processing techniques of Polygoni Multiflori Radix Praeparata based on chemical composition and color changes correlation
YAO Rui ; GUO Hong ; LI Zhe ; GUO Xiaohan ; ZHANG Xiaoshu ; DUAN Baozhong ; YANG Jianbo ; CHEN Jia ; JING Wenguang ; CHENG Xianlong ; WEI Feng
Drug Standards of China 2026;27(1):0100-0108
Objective: To investigate the correlation between the color parameters (L*, a*, b*, Eab* values) of Polygoni Multiflori Radix Praeparata powder prepared by different processing techniques and the contents of 2,3,5,4’-tetrahydroxystilbene-2-O-β-D-glucopyranoside, emodin, physcion, emodin-8-O-β-D-glucopyranoside, physcion-8-O-β-D-glucopyranoside.
Methods: The L*, a*, b* and Eab* values of Polygoni Multiflori Radix Praeparata powder prepared by different processing techniques were determined by spectrophotometer, and the contents of the five components were determined by high performance liquid chromatography. Secondly, SPSS 26.0 software and Simca 14.1 software were used to analyze the correlation.
Results: Through the hierarchical cluster analysis (HCA), it was found that the steamed samples and black bean steamed samples could be obviously divided into two categories: raw products and processed products. The processed products could be further divided into 2-8 h and 12-48 h. Pearson correlation analysis showed that the content of stilbene glycoside was significantly positively correlated with L*, a* and b* values (P<0.01). The a* value was significantly positively correlated with the content of emodin and physcion (P<0.01). Emodin-8-O-β-D-glucoside was positively correlated with L* value and b* value, while physcion-8-O-β-D-glucoside was negatively correlated with a* value. Partial least squares discriminant analysis (PLS) showed that 2,3,5,4’-tetrahydroxystilbene-2-O-β-D-glucoside (VIP=1.69) and emodin-8-O-β-D-glucoside (VIP=1.06) were the key variables affecting chromaticity characteristics (P<0.01).
Conclusion: The three processes of steaming, black bean steaming and black bean stewing are consistent in composition transformation and chromaticity variation, and stilbene glycoside can be used as a specific index component to characterize the processed color. Chromatic parameters can effectively reflect the processing progression and serve as quality monitoring indicators during production.
7.Prediction of acute cerebral infarction in patients with transient ischemic attack by different obesity indicators
Man ZHANG ; Hu CHEN ; Rui WANG ; Yang LIU ; Xiaohan SHI ; Nini MA ; Jing CHEN
Journal of Public Health and Preventive Medicine 2026;37(4):169-172
Objective To analyze the predictive value of different obesity indicators on acute cerebral infarction in patients with transient ischemic attack (TIA). Methods A total of 310 patients with TIA admitted to Tangdu Hospital of Air Force Medical University from March 2022 to September 2025 were selected and classified into non-event group (276 cases) and cerebral infarction group (34 cases) based on acute cerebral infarction within 90 days. The basic data and obesity-related indicators [body mass index (BMI), waist-to-hip ratio, body adiposity index (BAI), conicity index (C-index) and a body shape index (ABSI were compared. Multivariate logistic regression analysis was utilized to screen the independent influencing factors. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive efficiency. Results The age, proportions of concurrent hypertension and concurrent diabetes mellitus, ABCD2 score, waist-to-hip ratio, ABSI, C-index, BMI and BAI in the cerebral infarction group were older or higher than those in the non-event group, and the symptoms duration was longer (P<0.05). The above indicators were all related factors for acute cerebral infarction in patients with TIA within 90 days (P<0.05), and ABSI and ABCD2 score were independent influencing factors (P<0.05). The prediction model was manifested as Logit (P)=− 4.205 + 0.482 × ABCD2 score + 1.120 × ABSI × 100. ABSI and ABCD2 score had predictive value on the occurrence of acute cerebral infarction (P<0.05), and the predictive efficiency of combined model was higher than that of single indicator (P<0.05). Conclusion Among different obesity indicators, ABSI has the highest value on predicting recent acute cerebral infarction in TIA. The prediction model based on ABSI and ABCD2 score exhibits the best predictive efficiency.
8.Effects of Bushen Huoxue Formulation (补肾活血方) on Synaptic Vesicle-Associated Proteins in Neurons and the Intestinal Barrier in Parkinson's Disease Model Rats
Naxin WEI ; Yingfan CHEN ; Xiaorong QI ; Qian ZHANG ; Xiaohan GENG ; Yuzhi ZHANG ; Min LI
Journal of Traditional Chinese Medicine 2026;67(15):1640-1649
ObjectiveTo investigate the potential mechanisms underlying the therapeutic effects of Bushen Huoxue Formulation (补肾活血方, BSHXF) in Parkinson's disease (PD) from the perspectives of synaptic vesicle cycling and intestinal barrier function. MethodsForty-eight male SD rats were randomly divided into four groups, control group, model group, Madopar group, and BSHXF group, with 12 rats in each group. Except for the control group, rats were administered rotenone by gavage once daily for 4 consecutive weeks to establish a PD rat model. After successful modeling, rats in the BSHXF group received concentrated BSHXF solution by gavage at a dose of 13.5 g/(kg·d), while rats in the Madopar group received Madopar tablet suspension at 2 g/(kg·d). Rats in the control group and the model group were administered distilled water by gavage at 10 ml/(kg·d). All groups received continuous gavage treatment for 2 weeks. Motor function was evaluated using the open field test (total distance traveled, average speed, and total distance traveled in the central zone), rotarod test (latency to fall), and balance beam test (traversal time). Histopathological changes in colon tissues were observed by HE staining. Western Blotting was used to detect the protein levels of α-synuclein (α-syn), phosphorylated serine 129 α-synuclein (pSer129-α-syn), vesicle-associated membrane protein 2 (VAMP2), and synaptophysin (SYP) in the substantia nigra and colon tissues. The mRNA expression levels of α-syn, VAMP2, and SYP were detected by RT-PCR, and α-syn expression was examined by immunohistochemistry. Immunofluorescence staining was performed to assess the levels of tight junction protein 1 (ZO-1) and occludin in colon tissues, as well as tyrosine hydroxylase (TH) levels in substantia nigra tissues. ResultsCompared with the control group, rats in the model group showed reduced total distance traveled, average speed, and central-zone distance in the open field test, decreased latency to fall in the rotarod test, and prolonged traversal time in the balance beam test. The protein levels of pSer129-α-syn and α-syn, as well as α-syn mRNA expression were increased in the substantia nigra and colon tissues, whereas the protein and mRNA expression levels of VAMP2 and SYP were decreased. The relative integrated optical density of α-syn in the substantia nigra and colon tissues was increased, while the relative fluorescence intensities of ZO-1 and occludin in colon tissues and TH in the substantia nigra were decreased (P<0.05). HE staining showed focal necrosis in the mucosal layer of colon tissues, disappearance of some intestinal glands, extensive inflammatory cell infiltration, and proliferation of fibrous connective tissue in the submucosa. Compared with the model group, both the Madopar group and BSHXF group showed varying degrees of improvement in the above indicators (P<0.05). Pathological damage in colon tissues was also alleviated, with only mild fibrous tissue proliferation and limited diffuse inflammatory cell infiltration observed in the mucosal layer. Compared with the Madopar group, rats in the BSHXF group exhibited increased average speed, central-zone distance, and latency to fall in the rotarod test. The levels of pSer129-α-syn and α-syn proteins in the substantia nigra were decreased, while VAMP2 protein expression was increased. In colon tissues, SYP protein levels and mRNA expression were elevated. The relative fluorescence intensity of ZO-1 in colon tissues and TH in substantia nigra tissues was also increased (P<0.05). ConclusionBSHXF may improve motor dysfunction in PD by regulating synaptic vesicle cycling, restoring intestinal barrier integrity, and improving neuronal synaptic function through modulation of synaptic vesicle-associated protein expression in the substantia nigra and colon tissues.
9.Effects of Bushen Huoxue Formulation (补肾活血方) on Synaptic Vesicle-Associated Proteins in Neurons and the Intestinal Barrier in Parkinson's Disease Model Rats
Naxin WEI ; Yingfan CHEN ; Xiaorong QI ; Qian ZHANG ; Xiaohan GENG ; Yuzhi ZHANG ; Min LI
Journal of Traditional Chinese Medicine 2026;67(15):1640-1649
ObjectiveTo investigate the potential mechanisms underlying the therapeutic effects of Bushen Huoxue Formulation (补肾活血方, BSHXF) in Parkinson's disease (PD) from the perspectives of synaptic vesicle cycling and intestinal barrier function. MethodsForty-eight male SD rats were randomly divided into four groups, control group, model group, Madopar group, and BSHXF group, with 12 rats in each group. Except for the control group, rats were administered rotenone by gavage once daily for 4 consecutive weeks to establish a PD rat model. After successful modeling, rats in the BSHXF group received concentrated BSHXF solution by gavage at a dose of 13.5 g/(kg·d), while rats in the Madopar group received Madopar tablet suspension at 2 g/(kg·d). Rats in the control group and the model group were administered distilled water by gavage at 10 ml/(kg·d). All groups received continuous gavage treatment for 2 weeks. Motor function was evaluated using the open field test (total distance traveled, average speed, and total distance traveled in the central zone), rotarod test (latency to fall), and balance beam test (traversal time). Histopathological changes in colon tissues were observed by HE staining. Western Blotting was used to detect the protein levels of α-synuclein (α-syn), phosphorylated serine 129 α-synuclein (pSer129-α-syn), vesicle-associated membrane protein 2 (VAMP2), and synaptophysin (SYP) in the substantia nigra and colon tissues. The mRNA expression levels of α-syn, VAMP2, and SYP were detected by RT-PCR, and α-syn expression was examined by immunohistochemistry. Immunofluorescence staining was performed to assess the levels of tight junction protein 1 (ZO-1) and occludin in colon tissues, as well as tyrosine hydroxylase (TH) levels in substantia nigra tissues. ResultsCompared with the control group, rats in the model group showed reduced total distance traveled, average speed, and central-zone distance in the open field test, decreased latency to fall in the rotarod test, and prolonged traversal time in the balance beam test. The protein levels of pSer129-α-syn and α-syn, as well as α-syn mRNA expression were increased in the substantia nigra and colon tissues, whereas the protein and mRNA expression levels of VAMP2 and SYP were decreased. The relative integrated optical density of α-syn in the substantia nigra and colon tissues was increased, while the relative fluorescence intensities of ZO-1 and occludin in colon tissues and TH in the substantia nigra were decreased (P<0.05). HE staining showed focal necrosis in the mucosal layer of colon tissues, disappearance of some intestinal glands, extensive inflammatory cell infiltration, and proliferation of fibrous connective tissue in the submucosa. Compared with the model group, both the Madopar group and BSHXF group showed varying degrees of improvement in the above indicators (P<0.05). Pathological damage in colon tissues was also alleviated, with only mild fibrous tissue proliferation and limited diffuse inflammatory cell infiltration observed in the mucosal layer. Compared with the Madopar group, rats in the BSHXF group exhibited increased average speed, central-zone distance, and latency to fall in the rotarod test. The levels of pSer129-α-syn and α-syn proteins in the substantia nigra were decreased, while VAMP2 protein expression was increased. In colon tissues, SYP protein levels and mRNA expression were elevated. The relative fluorescence intensity of ZO-1 in colon tissues and TH in substantia nigra tissues was also increased (P<0.05). ConclusionBSHXF may improve motor dysfunction in PD by regulating synaptic vesicle cycling, restoring intestinal barrier integrity, and improving neuronal synaptic function through modulation of synaptic vesicle-associated protein expression in the substantia nigra and colon tissues.
10.Research progress on action mechanisms of complement C3/C5 in peri-implant immune microenvironment
Siyu CHEN ; Guangdao ZHANG ; Yujie TAO ; Xiaohan LIU ; Lin WU
Journal of Clinical Medicine in Practice 2025;29(12):130-134,148
Peri-implant diseases have a relatively high incidence,and immune-inflammatory re-sponses are closely associated with peri-implant mucositis and peri-implantitis.The complement sys-tem is a vital component of the immune system.Its activation not only regulates the initiation and pro-gression of inflammatory responses but also plays a crucial role in bone remodeling.This review sum-marizes the roles of the core complement components C3 and C5 in various stages of bone remodeling after implant placement,as well as in peri-implant mucositis and peri-implantitis.The aim of the pa-per was to provide novel insights for the prevention and treatment of peri-implantitis through targeted regulation of complement protein levels.


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